Transplantology

Overview

Transplantology can as well mean organ transplants and Transplantology abroad program. Therefore, involves a medical procedure that aims at the removal of a structure from the body and replacing it with another organ from the donor. The main objective of an organ transplant is to restore a damaged or a dead organ.

The organs that are normally transplanted are the kidneys, heart, liver, pancreas, lungs, and intestine. Tissues such as the tendons, bones, skin, nerves, veins, heart valves, and cornea can also be transplanted.

Transplantation Definition

Organ transplantation is a medical technique in which an organ is taken from one body and transplanted into the body of another in order to replace a damaged or missing organ. The donor and receiver may be in the same place, or the organs may be moved from one location to another. Autografts are organs and/or tissues that are transplanted within the same person's body. Allografts are transplants that have recently been conducted between two subjects of the same species. Allografts can come from either a live or a cadaveric source.

Heart, kidneys, liver, lungs, pancreas, intestine, thymus, and uterine transplants have all proven successful. Bones, tendons (both referred to as musculoskeletal grafts), corneae, skin, heart valves, nerves, and veins are examples of tissues. The kidneys are the most often transplanted organs in the world, followed by the liver and finally the heart. Corneae and musculoskeletal grafts are the most frequently transplanted tissues, outnumbering organ transplants by a factor of ten.

Donors of organs might be alive, brain dead, or deceased from circulatory death. Tissue can be retrieved from donors who died of circulatory death as well as brain death up to 24 hours after their heartbeat stopped. Most tissues, with the exception of corneas, may be kept and stored for up to five years, allowing them to be "banked." Transplantation poses a variety of bioethical concerns, such as the concept of death, when and how consent for an organ transplant should be provided, and remuneration for transplanted organs.

Other ethical concerns include transplantation tourism (medical tourism) and the socio-economic setting in which organ procurement or transplantation may take place. Organ trafficking is a special issue. There is also the ethical issue of not giving patients false hope.

Statistics

Organ donation can help people live longer and better lives. More than 80 people in the United States get donated organs every day. Many more must. According to the US Health Resources and Services Administration, 95% of Americans favor organ donation, yet only 58% have signed up to be donors.

By donating tissue, a single dead donor can save the lives of up to eight individuals and enhance the lives of more than 100 others. Some people are discouraged from giving their organs because of myths about organ donation. The following claims are false:

Doctors strive less hard to save organ donors' life.
An open casket is made impossible by organ donation.
The majority of faiths reject organ donation.
When a loved one donates an organ, families may be required to pay.

Donating an organ is completely free and can save or extend a person's life. With the aid of an organ donor, many individuals can live long and healthy lives. The impact of an organ transplant on a person's life expectancy depends on their age, the organ transplanted, and the cause for the transplant.

Not all donated organs are immortal. A kidney from a living donor has an average lifespan of 12–20 years, but a kidney from a deceased donor has an average lifespan of 8–12 years.

Types of Transplantation

These are the categories of transplantation surgery abroad:

Auto-transplantation

This involves organ transplantation within the body sections of the same person. This means that both the recipient and the donor are the same person. An example of such a situation is whereby the healthy skin is cut out and moved to a burnt or the injured part. It can also involve auto-transplantation of the stem cells and the bone marrow following an increased dose of anticancer chemotherapy in lymphoma or leukemia.

Homo-transplantation

This is where the organ donor is not immune or genetically matches with the recipient. Homo-transplantation is very common, and the most considered alternative. With this type of transplantation, organs from relatives of the recipient or any other donor can be used.

Iso-transplantation

This is a situation where the donor and the receiver are identical twins. This means that they are immune systems and genetics are similar. However, these form of transplants are minimal since the rate of identical twins in the world is relatively low. Also, they often suffer from the same kind of disorders.

Xenotransplantation

This involves transplantation from an organism of a different biological species, such as an animal to a human.

Common Types of Organ Transplants

Kidney Transplant

A kidney transplant is a procedure that helps cure kidney failure. The role of the kidneys involves filtering out the waste products in the blood and removing them through urine. Moreover, they maintain the balance of the electrolyte and fluids in the body. Therefore, if the kidneys fail to work, the waste products accumulate, hence making you ill.

People with kidney failure can undergo dialysis treatment. This procedure helps filter the waste products that accumulate in the blood due to kidney failure. However, if the kidneys completely fail or dies, then the appropriate medical alternative is organ transplant treatment abroad. Either one of the two kidneys are replaced with new kidneys from a living or dead person.

Heart Transplant

This is a procedure whereby a failed or damaged heart is replaced with a healthy one from the donor. This is a type of transplantation treatment abroad meant explicitly for individuals whose state of health has not advanced even after medications and surgeries. A heart transplant is one of the critical conditions; hence the probability of surviving depends on the follow-up care.

The heart supports almost all the functions of the body ranging from;

Pumping oxygenated blood, hormones, and other essential functions to various parts of the body.
Receiving deoxygenated blood and transporting wastes from the body towards the lungs for oxygenation.
Maintaining the standard blood pressure.

Therefore, any disease affecting the heart and its functions may cause death within a shorter period. The only way to prevent this and ensure that all these activities take place is to consider a heart transplant.

Liver Transplant

This involves the removal of the whole nonfunctional or dead liver and restoring it with a strong one. The donor can be deceased individual or a part of the liver from a living person. The liver is a vital organ that aids the filtration of the blood and gets rid of toxins from the body. A liver transplant is the only remedy for chronic long-term liver disorders.

See more about:Liver cancer

Lung Transplant

A lung transplant is an effective cure for conditions that destroy the lungs and their standard functions. It involves replacing the damaged lung with a new lung mainly from a deceased person.

This procedure is specifically reserved for a patient with serious cases who hasn't shown any sign of improvement. Therefore, people with critical lung conditions can undergo a transplant to restore their breathing system and live longer.

Pancreas Transplant

A pancreas transplant is a medical remedy for people with severe pancreas diseases who are unlikely to survive for a longer period. A damaged pancreas will be taken out and replaced with another one from a deceased individual.

Its primary function involves producing insulin. This is a significant hormone that regulates and controls sugar absorption in the cells. This thus means that a damaged pancreas cannot work accordingly to produce sufficient insulin. In such a situation, the level of blood sugar increases, causing diabetes.

Types of Donors

Not all donated organs are immortal. A kidney from a living donor has an average lifespan of 12–20 years, but a kidney from a deceased donor has an average lifespan of 8–12 years.

Breathing is sustained by artificial means, which also sustains heartbeat. Once brain death is recognized, the individual might be considered for organ donation. The criteria for brain death differ. Because brain death accounts for fewer than 3% of all fatalities in the United States, the vast majority of deaths are ineligible for organ donation, resulting in significant shortages.

Organ donation after cardiac death is conceivable in some circumstances, most notably when the individual is seriously brain-injured and unable to live without artificial breathing and mechanical assistance. A person's next-of-kin may elect to discontinue artificial assistance regardless of whether or not they contribute. If the individual is expected to die soon after support is removed, procedures can be made to withdraw such support in an operating room to allow for fast recovery of the organs after circulatory death.

Tissues can be obtained from donors who die of brain or circulatory death. Tissues can be collected from donors up to 24 hours after their heartbeat has stopped. Unlike organs, most tissues (excluding corneas) may be kept and stored for up to five years, allowing them to be "banked." A single tissue donor can also provide more than 60 transplants. Tissue transplants are far more prevalent than organ transplants because of these three factors: the capacity to recover from a non-heart-beating donor, the ability to bank tissue, and the quantity of grafts accessible from each donor.

Living donor

The donor stays alive and provides a renewable tissue, cell, or fluid (e.g., blood, skin), or donates an organ or part of an organ in which the remaining organ can regenerate or take on the burden of the remaining organ (primarily single kidney donation, partial donation of liver, lung lobe, small bowel). One day, regenerative medicine may allow for laboratory-grown organs made from a person's own cells via stem cells or healthy cells retrieved from failing organs.

Deceased donor

Deceased donors (previously cadaveric) are persons whose organs are maintained alive by ventilators or other artificial devices until they can be removed for transplantation. Apart from brainstem-dead donors, who have constituted the bulk of deceased donors for the last 20 years, after-circulatory-death donors (previously non-heart-beating donors) are increasingly being used to widen the possible pool of donors as demand for transplants continues to rise.

All dead organ donors died of circulatory death prior to the legal acknowledgment of brain death in the 1980s. These organs have poorer results than brain-dead donor organs. Due to biliary problems and primary nonfunction in liver transplantation, patients who received donation after circulatory death allografts had considerably worse graft survival than those who received donation after brain death allografts. Given the paucity of viable organs and the number of individuals who die while waiting, however, every possibly acceptable organ must be evaluated. Medically assisted suicide jurisdictions may coordinate organ donations from that source.

Significance of Organ Transplants

The significance of the transplant usually depends on the organ that a person receives. But generally, these are some of the major benefits of the procedure:

Prolong life
Avoid medical operations like dialysis
Live an improved and quality life
Live a healthy and less problematic life
Avoid frequent visits to the hospital, undergoing surgeries from time to time, and using drugs more often.
Rectify congenital abnormalities that can put a life in danger.

Tissue Transplants

This procedure is known as an autograft. It involves a transplant from one body part to another. Some of the tissue transplants include;

Blood vessel transplant: This is a surgical procedure that gives an alternative path for the blood to bypass the blocked or damaged artery.
Skin transplant: Involves moving a portion of the healthy skin to another body part.
Bone marrow transplant: This involves replacing the damaged blood stem cells with healthy bone marrow extracted from a different part.

See more about Lymphoma

Bone transplant: Helps rebuild the part of the body that has been damaged.

With tissue transplants, there are minimal chances of rejections since the cells are similar and from the same person. Due to this, medication to boost the immune system is not necessary. On the contrary, retrieving tissues opens up an additional wound, and the patient will have to manage both cases.

Preparation for the Transplant Procedure

Before the procedure, various things need to be taken into consideration. First, it’s essential to undergo tissue and blood tests. This helps determine if you and the donor are a match.

Secondly, you need to take good care of your overall health. For instance, adhering to the instructions by the doctor on healthy eating and working out, taking the medication accordingly, and undergoing regular blood tests.

Remember that it can take days, months, even up to years before the transplant procedure. Therefore, the most important thing is to wait and maintain a healthy lifestyle.

What to Expect After the Organ Transplant?

The outcomes of the transplant are not always immediate. For some people, it may take years before they eventually feel better and go back to their normal lives. The activities and everything you are supposed to do or avoid depend on the type of transplant, other health issues, and the reactions of the body to the new organ.

The doctor will prescribe some medications that will help ease the situation. Also, you may be required to take drugs regularly. This is to prevent organ rejection by the immune system. But as the situation gets better, you may need only a few of these drugs to keep you going.

During this period, you are prone to colds or various infections. This is because the anti-rejection drugs weaken the body's immune system. It will, therefore, be a good idea if you keep off crowded places for some time. Also, avoid interacting with people who have flu or any other infection.

Frequent blood tests and checkups are also essential as it helps monitor the adjustments and how the organ is working. Some common challenges you may experience are depression and making some lifestyle changes. Some of the lifestyle changes include consuming healthy meals, frequent exercise, and getting enough sleep.

What kind of exercise can I do?

When you initially go home, limit your activity and muscular strain. Consult your doctor. They will inform you of what to expect. And they'll advise you which activities to avoid. The majority of patients have weakness following surgery. You'll need time to recover following the surgery. You will also need to heal from the disease or accident that caused you to require a transplant.

Exercise will help you restore your strength once you feel better. At first, you may feel fatigued. During activity, take rest breaks. Increase the amount and sort of physical exercise you love gradually.

Risks Associated with Transplantology

The benefits of organ transplants normally exceed the associated risks. This is because a high percentage of the people who require an organ does not live a more extended period. They eventually die if the transplant procedure fails to take place. At the same time, the transplants involve a risky type of surgery, considering the fact that the patients in need are seriously sick.

So, these are the common risks of transplant surgery;

Bleeding and other severe complications
High chances of certain infections and diseases caused by transplant medications and anti-rejection drugs.
Complications caused by the use of anesthesia could lead to death.
After surgical complications, for example, frequent infections
Organ failure or rejection

Immunosuppressive Therapy

One of the most dreaded problems of any SOT is rejection. To avoid allograft rejection, transplant patients are often placed on life-long immunosuppressive regimes. The purpose of different immunosuppressive regimens is to inhibit T cell growth and cytotoxicity while simultaneously decreasing B cell antibody production. Immunosuppression methods are classified into three categories: induction regimens, maintenance therapy, and rejection treatment. Induction regimens are started before or during the transplant procedure.

High-dose steroids and anti-thymocyte globulin, alemtuzumab, or basiliximab are commonly utilized. Maintenance therapy often consists of a mixture of two to three immunosuppressants from different classes, such as tacrolimus, mycophenolate mofetil, and a corticosteroid.

Immunosuppression increases the risk of viral and bacterial infections such as CMV, herpes simplex virus, BK polyomavirus, tuberculosis, pseudomonas, pneumocystis carinii, toxoplasma gondii, candidiasis, aspergillus, Nocardia, and endemic fungi (histoplasmosis, cryptococcosis, coccidioidomycosis, etc.).

Many patients are put on long-term trimethoprim-sulfamethoxazole prophylaxis to avoid Pneumocystis carinii pneumonia. Skin cancer, lymphoma, and cervical cancer are also at an elevated risk, as is the development of major metabolic derangements.

Future Directions

Over the last 60 years, advances in the area of SOT have been revolutionary in terms of patient survival. Much of the current research seeking to broaden the discipline is centered on immunomodulation. Complex signaling molecules, cellular immunity, and humoral processes all play a role in the immune rejection. Future transplant research will concentrate on aiming to reduce the immune response by blocking portions of these multiple processes.

The Notch signaling pathway is an example of an immunomodulatory target. The Notch pathway is a cell-to-cell communication cascade that is essential for T cell development as well as the control of innate lymphoid cells, B cells, and dendritic cells. The signaling system plays an important role in T cell response to allografts. Inhibiting the Notch system in animal models has been demonstrated to minimize both allograft rejection and graft vs. host disease.

Other immune-related improvements in the field of transplantation aim for more focused immune system suppression. Operational tolerance, defined as a recipient's immunologic tolerance to the foreign organ in the absence of immunosuppressive medicines, is the ideal circumstance in organ transplant. Patients with operational tolerance do not require maintenance immunosuppression, and the consequences associated with such drugs, such as life-threatening infections and an increased risk of neoplasms, are avoided.

Donor-specific tolerance allows for the elimination or reduction of the requirement for immunosuppressive drugs. The use of hematopoietic stem cells has shown promise in a number of human instances and animal models. Initial pilot studies have yielded mixed but positive results. Three of seven patients who received a simultaneous bone marrow transplant and kidney transplant were able to discontinue all immunosuppressive drugs.

In another study, seven out of ten patients who developed chimerism after receiving HLA-mismatched kidney and bone marrow transplants achieved immunosuppression freedom for 4.5–11.4 years. persistent chimerism (greater than 6 months) resulted in the complete withdrawal of immunosuppressive drugs in 16 out of 22 patients. Despite the fact that the outcomes of such pilot human studies are encouraging, their acceptance and replicability have yet to be demonstrated.

Conclusion

Overall, Transplantology has helped solve a lot of health issues and even save many lives. Organs of the body such as the heart, liver, lungs, kidney, and pancreas, among others, play a very crucial role. The truth is if any of these organs fail then complex issues may result and could cause death in the long run.

Transplantology involves transferring an organ from one organism to the other; mainly from the donor to the recipient. This is one of the most critical procedures anyone can undergo; hence it's essential to opt for the best medical clinic with the best services.